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OBJECTIVES/GOALS: The goal of this study is to investigate the potential independent relationship between epicardial adipose tissue (EAT) and cardiometabolic health in youth-onset type 2 diabetes (T2D) and explore changes in EAT as a potential mediator of changes in cardiometabolic health in response to vertical sleeve gastrectomy (VSG). METHODS/STUDY POPULATION: We will assess glycemic control, insulin sensitivity and secretion in youth with T2D before and 3 months after VSG. Fasting labs, anthropometrics, and a 4-hour, frequently sampled liquid mixed meal tolerance test (45g carbohydrates, 14g fat, and 14g protein) were performed. Calculations included glucose, insulin, and GLP-1 area under the curve (AUC), Matsuda Index, HOMA-IR, and oral disposition index (DI). These cardiometabolic outcomes will then be assessed for associations between total EAT volume, measured from cardiac MRI. RESULTS/ANTICIPATED RESULTS: Previous studies have shown that individuals with obesity have higher EAT than lean controls, and adults with T2D have even higher EAT than obese controls. Therefore, we anticipate that our participants will have higher volume of EAT than what has been reported in the literature and that they will have worsening cardiometabolic outcomes without MBS. Our anticipated results will include: Weight and BMI, hemoglobin A1c, diabetes medications, Matsuda Index, HOMA-IR, DI, and glucose and insulin AUC during an MMTT. Cardiac MRI's are being analyzed and will give total EAT volume and will be analyzed for correlations with the cardiometabolic outcomes of body composition, aortic stiffness, blood pressure, cardiac structure and function, as well as lipid panel and insulin sensitivity. DISCUSSION/SIGNIFICANCE: This study is the first to specifically assess EAT in adolescents with T2D. The assessment of EAT will be done with gold-standard MRI and correlated with cardiometabolic health assessed by gold-standard methods. Together, the results will give insight into EAT as a potential independent cardiometabolic risk factor in adolescents undergoing VSG.
To examine differences in surgical practices between salaried and fee-for-service (FFS) surgeons for two common degenerative spine conditions. Surgeons may offer different treatments for similar conditions on the basis of their compensation mechanism.
The study assessed the practices of 63 spine surgeons across eight Canadian provinces (39 FFS surgeons and 24 salaried) who performed surgery for two lumbar conditions: stable spinal stenosis and degenerative spondylolisthesis. The study included a multicenter, ambispective review of consecutive spine surgery patients enrolled in the Canadian Spine Outcomes and Research Network registry between October 2012 and July 2018. The primary outcome was the difference in type of procedures performed between the two groups. Secondary study variables included surgical characteristics, baseline patient factors, and patient-reported outcome.
For stable spinal stenosis (n = 2234), salaried surgeons performed statistically fewer uninstrumented fusion (p < 0.05) than FFS surgeons. For degenerative spondylolisthesis (n = 1292), salaried surgeons performed significantly more instrumentation plus interbody fusions (p < 0.05). There were no statistical differences in patient-reported outcomes between the two groups.
Surgeon compensation was associated with different approaches to stable lumbar spinal stenosis and degenerative lumbar spondylolisthesis. Salaried surgeons chose a more conservative approach to spinal stenosis and a more aggressive approach to degenerative spondylolisthesis, which highlights that remuneration is likely a minor determinant in the differences in practice of spinal surgery in Canada. Further research is needed to further elucidate which variables, other than patient demographics and financial incentives, influence surgical decision-making.
Public-Private Innovation Partnerships (PPIPs) are increasingly used as a tool for addressing ‘wicked’ public sector challenges. ‘Innovation’ is, however, frequently treated as a ‘magic’ concept: used unreflexively, taken to be axiomatically ‘good’, and left undefined within policy programmes. Using McConnell’s framework of policy success and failure and a case study of a multi-level PPIP in the English health service (NHS Test Beds), this paper critically explores the implications of the mobilisation of innovation in PPIP policy and practice. We highlight how the interplay between levels (macro/micro and policy maker/recipient) can shape both emerging policies and their prospects for success or failure. The paper contributes to an understanding of PPIP success and failure by extending McConnell’s framework to explore inter-level effects between policy and innovation project, and demonstrating how the success of PPIP policy cannot be understood without recognising the particular political effects of ‘innovation’ on formulation and implementation.
In this article I caution that María Lugones's critiques of Kimberlé Crenshaw's intersectional theory posit a dangerous form of epistemic erasure, which underlies Lugones's decolonial methodology. This essay serves as a critical engagement with Lugones's essay “Radical Multiculturalism and Women of Color Feminisms” in order to uncover the decolonial lens within Crenshaw's theory of intersectionality. In her assertion that intersectionality is a “white bourgeois feminism colluding with the oppression of Women of Color,” Lugones precludes any possibility of intersectionality operating as a decolonial method. Although Lugones states that her “decolonial feminism” is for all women of color, it ultimately excludes Black women, particularly with her misconstruing of Crenshaw's articulation of intersectionality that is rooted within the Black American feminist tradition. I explore Lugones's claims by juxtaposing her rendering of intersectionality with Crenshaw's and conclude that Lugones's decolonial theory risks erasing Black women from her framework.
In the present study, we aimed to compare anthropometric indicators as predictors of mortality in a community-based setting.
We conducted a population-based longitudinal study nested in a cluster-randomized trial. We assessed weight, height and mid-upper arm circumference (MUAC) on children 12 months after the trial began and used the trial’s annual census and monitoring visits to assess mortality over 2 years.
Children aged 6–60 months during the study.
Of 1023 children included in the study at baseline, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score and MUAC classified 777 (76·0 %), 630 (61·6 %), 131 (12·9 %) and eighty (7·8 %) children as moderately to severely malnourished, respectively. Over the 2-year study period, fifty-eight children (5·7 %) died. MUAC had the greatest AUC (0·68, 95 % CI 0·61, 0·75) and had the strongest association with mortality in this sample (hazard ratio = 2·21, 95 % CI 1·26, 3·89, P = 0·006).
MUAC appears to be a better predictor of mortality than other anthropometric indicators in this community-based, high-malnutrition setting in Niger.
Background: Cervical sponylotic myelopathy (CSM) may present with neck and arm pain. This study investiagtes the change in neck/arm pain post-operatively in CSM. Methods: This ambispective study llocated 402 patients through the Canadian Spine Outcomes and Research Network. Outcome measures were the visual analogue scales for neck and arm pain (VAS-NP and VAS-AP) and the neck disability index (NDI). The thresholds for minimum clinically important differences (MCIDs) for VAS-NP and VAS-AP were determined to be 2.6 and 4.1. Results: VAS-NP improved from mean of 5.6±2.9 to 3.8±2.7 at 12 months (P<0.001). VAS-AP improved from 5.8±2.9 to 3.5±3.0 at 12 months (P<0.001). The MCIDs for VAS-NP and VAS-AP were also reached at 12 months. Based on the NDI, patients were grouped into those with mild pain/no pain (33%) versus moderate/severe pain (67%). At 3 months, a significantly high proportion of patients with moderate/severe pain (45.8%) demonstrated an improvement into mild/no pain, whereas 27.2% with mild/no pain demonstrated worsening into moderate/severe pain (P <0.001). At 12 months, 17.4% with mild/no pain experienced worsening of their NDI (P<0.001). Conclusions: This study suggests that neck and arm pain responds to surgical decompression in patients with CSM and reaches the MCIDs for VAS-AP and VAS-NP at 12 months.
Background: Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord impairment. In a public healthcare system, wait times to see spine specialists and eventually access surgical treatment for CSM can be substantial. The goals of this study were to determine consultation wait times (CWT) and surgical wait times (SWT), and identify predictors of wait time length. Methods: Consecutive patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) prospective and observational CSM study from March 2015 to July 2017 were included. A data-splitting technique was used to develop and internally validate multivariable models of potential predictors. Results: A CSORN query returned 264 CSM patients for CWT. The median was 46 days. There were 31% mild, 35% moderate, and 33% severe CSM. There was a statistically significant difference in median CWT between moderate and severe groups; 207 patients underwent surgical treatment. Median SWT was 42 days. There was a statistically significant difference in SWT between mild/moderate and severe groups. Short symptom duration, less pain, lower BMI, and lower physical component score of SF-12 were predictive of shorter CWT. Only baseline pain and medication duration were predictive of SWT. Both CWT and SWT were shorter compared to a concurrent cohort of lumbar stenosis patients (p <0.001). Conclusions: Patients with shorter duration (either symptoms or medication) and less neck pain waited less to see a spine specialist in Canada and to undergo surgical treatment. This study highlights some of the obstacles to overcome in expedited care for this patient population.
Field experiments were conducted in 2000 and 2001 near Painter, VA, to evaluate the potential of sulfentrazone for use in potato. Sulfentrazone was applied at 0.11, 0.14, 0.21, and 0.28 kg ai/ha preemergence (PRE) alone or in combination with metolachlor or metribuzin, or at emergence (AT EMERG) of potato to simulate a delayed PRE application where the herbicide would come into contact with potato foliage. Potato injury from sulfentrazone PRE at rates of up to 0.21 kg/ha was generally similar to injury from metribuzin, metolachlor, or metribuzin plus metolachlor PRE. However, AT EMERG applications resulted in excessive injury that ranged from 60 to 86%. AT EMERG applications also caused decreased potato height and alterations in potato-flowering patterns. Sulfentrazone at either application timing controlled common lambsquarters at least 98% even at the lowest rates and was more effective than metribuzin or metolachlor alone. Higher rates of sulfentrazone (0.28 kg/ha) also controlled goosegrass and large crabgrass. However, sulfentrazone at 0.28 kg/ha controlled common ragweed only 58%. Total potato yield and grade with sulfentrazone PRE applications were similar to those of potato treated with metribuzin, metolachlor, or metribuzin plus metolachlor in both years. Potato injury from AT EMERG applications of sulfentrazone plus metolachlor decreased total potato yield and caused changes in the grade distribution of B-size, small A–size, and extra-large potato in 2000.
The failure of glyphosate to control all weeds throughout the entire growing season has sometimes prompted growers to use herbicides other than glyphosate on glyphosate-resistant soybean. Field studies were conducted in 1999 and 2000 to investigate potential crop injury by several herbicides in glyphosate-resistant soybean and to determine the relationships between soybean maturity group, planting date, and herbicide treatment on soybean injury, leaf area index (LAI), and yield. Glyphosate-resistant soybean generally recovered from early-season herbicide injury and LAI reductions; however, some treatments reduced yield. Yield reductions were more common in double-crop soybean than in full-season soybean. In full-season soybean, most yield reductions occurred in the early-maturing ‘RT-386’ cultivar. These yield reductions may be attributed to reduced developmental periods associated with early-maturing cultivars and double-crop soybean that often lead to reduced vegetative growth and limited LAI. Reductions in LAI by some herbicide treatments were not necessarily indicative of yield loss. Further yield reductions associated with herbicide applications occurred, although soybean sometimes produced leaf area exceeding the critical LAI level of 3.5 to 4.0, which is the minimum LAI needed for soybean to achieve maximum yield. Therefore, LAI response to herbicide treatments does not always accurately indicate the response of glyphosate-resistant soybean yield to herbicides.
The northeastern sector of the Rub' al-Khali desert in the eastern United Arab Emirates (UAE) is dominated by large NE–SW trending dune ridges orientated perpendicular to the currently prevailing northwesterly wind regime. In this study, extensive use has been made of artificially exposed sections through these major dune ridges that reveal internal sedimentary structures and allow an intensive, high-resolution sampling programme to be carried out. Here, we present the optical dating results for samples from 7 sections. The results indicate that dune activity and preservation occurred within the periods 7–3 ka, 16–10 ka and 22–20 ka with evidence of earlier preservation during marine oxygen isotope stages MIS 3 and 5, with net accumulation rates in the range 2.2–25 m.ka− 1. In several instances, hiatuses in the preserved record of dune accumulation coincide with stratigraphic bounding surfaces visible in the exposed section profiles with associated truncation of internal sedimentary structures. Caution must be exercised when interpreting such gaps in the recorded accumulation chronologies of these dunes since these may simply constitute phases of low preservation potential rather than phases of low aeolian activity. Other factors such as sediment supply and availability in relation to sea-level dynamics may be significant and are also considered.
Field experiments were conducted on the Eastern Shore of Virginia from 1999 to 2001 to evaluate the effects of tank mixture applications of isopropylamine or trimethylsulfonium salts of glyphosate with two liquid formulations of manganese (Mn lignin or Mn chelate) on spray solution pH and weed control in glyphosate-resistant soybean. Additions of manganese to herbicide solutions resulted in a reduction in the acidifying effects of the herbicides as well as in the control of common lambsquarters, large crabgrass, morningglory spp., and smooth pigweed. Reduced control caused by manganese could be overcome with higher rates of the herbicides on some species, but reduced control of common lambsquarters was seen when manganese was included with any herbicide application rate. For most species, Mn chelate caused a greater reduction in control than did Mn lignin. Although manganese caused significant decreases in weed control, soybean yield was not influenced by glyphosate salt, application rate, or manganese. Reduced weed control caused by the addition of manganese to herbicide solutions may be due to the complexing of the herbicide formulations, which could result in the formation of insoluble salt complexes that are not readily absorbed through the plant cuticle, resulting in decreased glyphosate phytotoxicity.
Field studies were conducted in 1996 and 1997 to evaluate response of eight peanut cultivars to flumioxazin applied preemergence (PRE) at 71 g ai/ha. Peanut cultivars evaluated include ‘NC 12C’, ‘NC 7’, ‘VAC 92R’, ‘NC-V 11’, ‘NC 10C’, ‘AT VC 1’, ‘NC 9’, and the experimental breeding line ‘N9001OE’. Visible injury 3 wk after planting in 1996 was 3% or less regardless of cultivar. In 1997, all cultivars were injured 15 to 28% with flumioxazin PRE, except VC 1, which was injured 45%. No visible injury was observed at 5 and 9 wk after planting. Flumioxazin did not influence the incidence of early leaf spot, late leaf spot, southern stem rot, cylindrocladium black rot, or tomato spotted wilt virus. Flumioxazin did not affect percentage of extra-large kernels, sound mature kernels, other kernels, and total yield.
Field studies were conducted to compare the effectiveness of PRE and POST applications of a prepackaged mixture of flufenacet plus metribuzin with that of diclofop for winter wheat tolerance and control of Italian ryegrass. Additional studies investigated the effectiveness of reduced rates of flufenacet plus metribuzin applied POST to Italian ryegrass when wheat was in the spike stage. All PRE and POST applications of flufenacet plus metribuzin produced similar or greater injury to wheat and more consistent control of Italian ryegrass than PRE or POST applications of diclofop. PRE applications of flufenacet plus metribuzin controlled Italian ryegrass 73 to 77%, whereas POST applications controlled Italian ryegrass 77 to 99%. PRE applications of diclofop controlled Italian ryegrass 57%; POST application controlled Italian ryegrass 78%. Wheat injury from flufenacet plus metribuzin applications varied with application rate, cultivar, and year of application.
Field experiments were conducted in 1996, 1999, and 2000 to evaluate weed control and snap bean response to postemergence applications of fomesafen at registered and reduced rates. S-Metolachlor was applied preemergence to all plots to suppress annual grasses. Snap bean injury generally increased as fomesafen rate increased, but at rates up to 0.28 kg ai/ha, injury by fomesafen was similar to or less than that from bentazon. Fomesafen at rates as low as 0.07 kg/ha provided near-complete control of common ragweed, and rates of 0.14 kg/ha or more of fomesafen controlled ivyleaf and pitted morningglories and 5-cm or smaller common lambsquarters as effectively as did bentazon. Control of all weed species from fomesafen alone at 0.21 kg/ha did not improve with the addition of bentazon at 0.28 kg/ha. Although snap bean injury from fomesafen was as high as 43% 1 wk after treatment, snap bean yield and net returns were similar to those from S-metolachlor alone. In a rate and application timing study, fomesafen at 0.14 kg/ha applied to three-trifoliolate snap bean was the least injurious to the crop, whereas applications at 0.28 kg/ha to one- or two-trifoliolate snap bean provided the best weed control.
Studies were conducted in 2000 and 2001 to investigate responses of glyphosate-resistant cotton, glyphosate-resistant soybean, and selected weed species to postemergence applications of isopropylamine (Ipa) and diammonium (Dia) salts of glyphosate at selected rates ranging from 0.42 to 3.36 kg ae/ha. No differences were detected between either glyphosate salts or application timings for cotton injury, cotton lint yield, micronaire, fiber length, fiber strength, or fiber uniformity. In a weed-free soybean study, no differences in soybean injury occurred between early-postemergence treatments of the two glyphosate salts. Injury from late-postemergence treatments did not exceed 12% with glyphosate-Ipa or 9% with glyphosate-Dia at 3.36 kg/ha. Soybean treated with glyphosate-Ipa yielded 3,050 kg/ha, whereas soybean treated with glyphosate-Dia yielded 2,880 kg/ha, when averaged over glyphosate rate and application timing. In a soybean study that included weed control as a variable, weed control at 14 d after treatment (DAT), and soybean yield was independent of glyphosate salt. Control of common ragweed, ivyleaf morningglory, pitted morningglory, and large crabgrass at 28 DAT was similar at 0.84 kg/ha of either glyphosate salt.
Field studies were conducted in 1996 and 1997 to evaluate response of eight peanut cultivars to diclosulam applied preplant incorporated at 36 g ai/ha in a weed-free environment. Peanut cultivars evaluated included ‘NC 12C’, ‘NC 7’, ‘VAC 92R’, ‘NC-V 11’, ‘NC 10C’, ‘AT VC 1’,‘NC 9’, and the experimental breeding line N90010E. Visible injury 3 wk after planting was less than 5% regardless of cultivar. No injury was observed at 21 d after planting. Diclosulam did not influence the incidence of early leaf spot, late leaf spot, southern stem rot, cylindrocladium black rot, or tomato spotted wilt virus. Diclosulam did not affect percentage of extra large kernels, sound mature kernels, other kernels, and yield.
Experiments were conducted in Virginia in 2000 and 2001 to investigate responses of winter wheat and diclofop-sensitive and -resistant Italian ryegrass to the experimental herbicide mixture AE F130060 03 and crop safener AE F107892 applied postemergence. AE F130060 03 at 15 or 18 g ai/ha with or without methylated seed oil controlled both diclofop-sensitive and -resistant Italian ryegrass 82 to 99% and reduced inflorescence emergence 59 to 98%. Although AE F130060 03 controlled existing Italian ryegrass 4 wk after any application, timing of application influenced late-season Italian ryegrass control and inflorescence emergence. Applications to two- to three-leaf Italian ryegrass resulted in greater emergence of Italian ryegrass after application than applications made to two- to three-tiller or four- to five-tiller Italian ryegrass. Wheat injury by AE F130060 03 was greater than injury from diclofop, but wheat appeared to fully recover; and yields from AE F130060 03–treated wheat were similar to yields of diclofop-treated wheat and at least 21% greater than yields from nontreated wheat. In greenhouse experiments, differential growth responses between diclofop-sensitive and -resistant Italian ryegrass occurred after AE F130060 03 application at normal (15 g ai/ha) and below-normal application rates. When rates were increased beyond normal application rates, growth responses were similar between diclofop-sensitive and -resistant Italian ryegrass.
The coastline along the southern Arabian Gulf between Al Jubail, Kingdom of Saudi Arabia, and Dubai, UAE, appears to have risen at least 125 m in the last 18,000 years. Dating and topographic surveying of paleo-dunes (43–53 ka), paleo-marine terraces (17–30 ka), and paleo-marine shorelines (3.3–5.5 ka) document a rapid, > 1 mm/a subsidence, followed by a 6 mm/a uplift that is decreasing with time. The mechanism causing this movement remains elusive but may be related to the translation of the coastal area through the backbasin to forebulge hinge line movement of the Arabian plate or, alternatively, by movement of the underlying Infracambrian-age Hormuz salt in response to sea-level changes associated with continental glaciation. Independent of the mechanism, rapid and episodic uplift may impact the design of engineering projects such as nuclear power plants, airports, and artificial islands as well as the interpretation of sedimentation and archeology of the area.
Field studies were established at two Missouri locations in 2004 and 2005 to evaluate the effects of fall and early spring herbicide applications on soil temperature, soil moisture content, and insect injury in no-till corn production systems. Both experiments received applications of simazine plus 2,4-D, rimsulfuron plus thifensulfuron plus 2,4-D, and glyphosate plus 2,4-D in the fall, 45 d prior to planting (45 d EPP), 30 d prior to planting (30 d EPP), and 7 d prior to planting (7 d EPP). During a period from April 1 to April 14, simazine plus 2,4-D applied 45 d EPP resulted in higher soil temperatures at a 5-cm depth compared to the untreated control. However, there were few differences in soil temperature present from April 15 to May 1. Soil moisture readings taken during this same time period correlated with soil temperature readings. Measurements of soil moisture taken at 1 and 3 wk after planting (WAP) revealed significantly lower soil moisture readings in the untreated compared to herbicide treated plots. This lower soil moisture content allowed untreated plots to warm up more rapidly and thereby eliminated any negative impacts that dense stands of winter annual weeds may have had on soil temperature. Evaluations of corn flea beetle and lepidopteron injury taken at the V2, V4, and V6 corn leaf stages revealed significant differences in injury as a result of these treatments. When dense stands of winter and summer annual weeds were left uncontrolled, corn flea beetle injury was significantly lower than in plots treated with a herbicide. However, when a post herbicide application was made to remove all weed species prior to the V6 sampling date, differences in corn flea beetle injury between the untreated and herbicide treated plots were eliminated. Additionally, removal of all weed species led to higher lepidopteron injury in the untreated.
Nitrous oxide (N2O) is a potent greenhouse gas with implication
for climate change. Agriculture accounts for 10% of all greenhouse gas
emissions in the United States, but 75% of the country's N2O
emissions. In the absence of PRE herbicides, weeds compete with soybean for
available soil moisture and inorganic N, and may reduce N2O
emissions relative to a weed-free environment. However, after weeds are
killed with a POST herbicide, the dead weed residues may stimulate
N2O emissions by increasing soil moisture and supplying carbon
and nitrogen to microbial denitrifiers. Wider soybean rows often have more
weed biomass, and as a result, row width may further impact how weeds
influence N2O emissions. To determine this relationship, field
studies were conducted in 2013 and 2014 in Arlington, WI. A two-by-two
factorial treatment structure of weed management (PRE + POST vs. POST-only)
and row width (38 or 76 cm) was arranged in a randomized complete block
design with four replications. N2O fluxes were measured from
static gas sampling chambers at least weekly starting 2 wk after planting
until mid-September, and were compared for the periods before and after weed
termination using a repeated measures analysis. N2O fluxes were
not influenced by the weed by width
interaction or width before termination, after termination,
or for the full duration of the study at P ≤ 0.05. Interestingly, we
observed that POST-only treatments had lower fluxes on the sampling day
immediately prior to POST application (P = 0.0002), but this was the only
incidence where weed influenced N2O fluxes, and
overall, average fluxes from PRE + POST and POST-only treatments were not
different for any period of the study. Soybean yield was not influenced by
width (P = 0.6018) or weed by
width (P = 0.5825), but yield was 650 kg ha−1
higher in the PRE + POST than POST-only treatments (P = 0.0007). These
results indicate that herbicide management strategy does not influence
N2O emissions from soybean, and the use of a PRE herbicide
prevents soybean yield loss.